A significant rise in elderly population (above 60 years) is evident across the globe due to reduced mortality, higher life expectancy indicating better preventive & treatment modalities with advanced technologies. However, the health seeking behavior of this population is worth exploring. Just to mention that most of these patients cannot confirm their real age due to lack of any documented evidence or even may not be sure due to decline in memory. Most of the time age is gauzed based on major events that happened in the past like Independence Day, disease epidemics, natural calamities etc.
Elderly can be further grouped on the basis of gender, educational background and their socio-economic background. The motive for seeking their health care and decision regarding treatment of illness may be different in elderly patients than younger age groups. Ironically elderly cannot separate their old age with existing illnesses. They frequently associate the poor treatment response to their age. On the other hand few of the cases in this age group complains of not being given proper attention by the doctors. Chronically ill patient lose all hopes and see the doctor only to satisfy the family members. On several occasional elderly are found crying while narrating their illnesses only to get minor relief.
A lot of time it is difficult to convince elderly patient to adhere to their treatment. Not uncommonly doctor face the dilemmas of different opinion of the patient and his family member. There are several occasions when elderly is living alone with or without their spouse and are free to take the decisions. Their decisions are usually based on the severity of illness, chronicity and the age. In absence of any family member or caregiver they tend to escape any procedural treatment, hospitalization, or any newer mode of treatment. With decreasing cognitive functions and altered mental status, elderly is vulnerable for non-adherence to the treatment leading to several complications and poor clinical outcome.
Further, dispensing drugs for elderly patients may be challenging as many barriers prevent them to take right medications. Besides cognitive decline it also includes fixed budget and poor social support. Additionally, this age group is more prone for drug related adverse effects that can scare them to take long term treatment. At times elderly are unable to tell their medicines to pharmacists or doctors. Due to fixed budget and limited access to health care elderly are often found taking non-prescription products (OTC) that they never disclose to their doctors. Quite often these OTC products contains active ingredients that can alter the drug response or even modify disease outcome. On detailed discussion with these patients, one can find their only goal of treatment is to maintain good quality of life irrespective of amelioration or cure of the underlying disease. This goal often restrains them to take opinion from specialists or a new doctor. They prefer to continue with the same doctor feeling emotional bonding irrespective his limitation on giving complete or potentially better treatment.
The patient behavior is also influenced by the age of the doctor that reflects their level of confidence shown towards healthcare provider. Elderly patient consulting a young physician may not disclose all his sufferings considering lack of understanding by the doctor. Moreover, they feel that age related illnesses would not be of much interest to the young doctor. Same patient visiting a senior physician may detail all his problems even with few exaggerations. The patients expect empathy from their doctors besides the prescribed medicines. Often patient closely observes the body language of his doctor and accordingly manipulate history of his illness. Needless to say, a sympathetic listening to the patient without interruption would give more information than hasty communication with specific questions often seen in busy clinics.